Pennsylvania dealing with rash of heroin overdoses

Tests ongoing to find if Fentanyl-laced batch was involved in actor's overdose.

February 06, 2014|By Tim Darragh, Of The Morning Call

Pennsylvania is in the midst of an "alarming" surge of cheap, potent heroin that caused a rash of deaths in the western part of the state last month, state health officials say.

Tainted, high-potency heroin killed at least 22 people in the Pittsburgh region last month and may be implicated in the death of actor Philip Seymour Hoffman.

Even before that, Pennsylvania was being flooded by powerful heroin produced by Mexican drug cartels.

"It's a huge crisis," said Gary Tennis, director of the Pennsylvania Department of Drug and Alcohol Programs.

According to a report by the Pennsylvania State Coroners Association last year, heroin-related fatalities rose steadily from 332 in 2009 to 827 in 2012 in 40 counties that were surveyed. A partial report from 2013 counted 524 fatalities through the summer. Over that time period, a total of 2,676 people statewide died overdosing on heroin or a combination of heroin and other drugs.

In addition, the report showed that white males ages 20-50 are disproportionately the victims of fatal heroin overdoses.

The extra-potent drug has not turned up in the Lehigh Valley. That it was found in western Pennsylvania — and in Lebanon County last year — and not elsewhere in the state doesn't mean it won't show up in other areas, Tennis said.

"It just so happens the batches coming into the Lehigh Valley don't have it," he said, referring to heroin laced with the painkiller fentanyl. "It could just as easily be the other way around."

The coroners for Lehigh and Northampton counties this week said they have not seen cases of people overdosing on heroin mixed with other opiates. That's not to say the Lehigh Valley hasn't had its share of fatal heroin overdoses.

Rather than overdosing from a deadly type of heroin, it appears heroin users here "chose to do too much, or the purity was greater than their body could handle," Northampton County Coroner Zachary Lysek said.

According to the coroners association report, fatalities caused by heroin or a combination of heroin and other substances, including opioids, alcohol or other drugs, fluctuated locally.

Since 2009, it said, Lehigh County had 40 deaths of people using heroin in combination with other substances.

In Northampton County, 18 people died in that time period from heroin-only overdoses. The county reported 141 fatal drug overdoses from 2009-2013, but its report lumped all multi-drug overdoses together, whether they included heroin or not.

Heroin is bad enough, but adding other drugs or substances can make it a more deadly choice, said Alan Cowan, professor emeritus of pharmacology at Temple University's Center for Substance Abuse Research. He said middlemen and dealers will stretch batches of the drug by mixing it with all kinds of substances, even brick dust.

"The main problem is, what are you injecting?" Cowan said.

In the case of Hoffman, who was found dead Sunday in his apartment in New York City, authorities are investigating whether the suspected heroin they found was strengthened by fentanyl — like heroin, an opiate that depresses respiration.

His death "really brought home how dangerous heroin is," Cowan said.

At a legislative hearing in November, Attorney General Kathleen Kane said that for the first time, heroin had replaced cocaine as "the drug of choice" in Pennsylvania. She said the supply is coming from Mexican cartels who in years past had not distributed east of the Mississippi River, a development she called "very alarming."

"The increased production of heroin in Mexico and the transportation of huge quantities across the southwest border is throwing more and more heroin into Pennsylvania," she testified at a House Judiciary Committee hearing.

"The Mexican-produced heroin is purer and cheaper," she said, adding that a bag of heroin that once cost $20 on the street now costs about half as much.

Tennis convened a rapid response task force last year to improve ways of identifying heroin hot spots. The task force includes health professionals, law enforcement officials, coroners, hospitals and representatives from a number of state offices, he said.

Gov. Tom Corbett's Healthy PA plan also could help fight heroin abuse by increasing the income eligibility limits for people applying for Medicaid, and broadening coverage for people seeking drug and alcohol treatment, Tennis said. If approved, the changes would include covering outpatient treatment, which currently is not covered, he said.

It's a "historic step forward in terms of getting people the treatment they need," Tennis said.

Healthy PA also calls for placing hundreds of drug collection boxes in police stations around Pennsylvania, where people could dump unneeded medications, he noted.

Powerful prescription painkillers such as oxycodone have stoked the demand for heroin, Tennis said.

"Many, many of the people on heroin transitioned from prescription opioids," he said. "That really is the ultimate cause of our current heroin crisis."